The DOI matches its Crossref record; 33 of the 34 references it cites were found in a registry or an index.
A randomized controlled trial of a therapeutic relational agent for reducing substance misuse during the COVID-19 pandemic
Open accessAbstract
BACKGROUND: The COVID-19 pandemic disrupted access to treatment for substance use disorders (SUDs), while alcohol and cannabis retail sales increased. During the pandemic, we tested a tailored digital health solution, Woebot-SUDs (W-SUDs), for reducing substance misuse. METHODS: In a randomized controlled trial, we compared W-SUDs for 8 weeks to a waitlist control. U.S. adults (N = 180) who screened positive for substance misuse (CAGE-AID>1) were enrolled June-August 2020. The primary outcome was the change in past-month substance use occasions from baseline to end-of-treatment (EOT). Study retention was 84%. General linear models tested group differences in baseline-to-EOT change scores, adjusting for baseline differences and attrition. RESULTS: At baseline, the sample (age M = 40, SD = 12, 65% female, 68% non-Hispanic white) averaged 30.2 (SD = 18.6) substance occasions in the past month. Most (77%) reported alcohol problems, 28% cannabis, and 45% multiple substances; 46% reported moderate-to-severe depressive symptoms. Treatment participants averaged 920 in-app text messages (SD = 892, Median = 701); 96% of completed lessons were rated positively; and 88% would recommend W-SUDs. Relative to waitlist, W-SUDs participants significantly reduced past-month substance use occasions (M = -9.1, SE = 2.0 vs. M = -3.3, SE = 1.8; p = .039). Secondary substance use and mood outcomes did not change significantly by group; however, reductions in substance use occasions correlated significantly with increased confidence and fewer substance use problems, cravings, depression and anxiety symptoms, and pandemic-related mental health effects (p-value<.05). CONCLUSIONS: W-SUDs was associated with significant reductions in substance use occasions. Reduction in substance use occasions was associated with better outcomes, including improved mental health. W-SUDs satisfaction was high.
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“A study of the chatbot app Woebot, used to help reduce substance misuse, found that greater frequency of use (numbers of in-app text) was not significantly associated with a reduction in substance use occasions (r = 0.23) (50).”
From Digital Therapeutic Alliance With Fully Automated Mental Health Smartphone Apps: A Narrative Review (2022) · cites this paper as [50]
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“A study of the app Woebot (a therapeutic chatbot that delivers CBT), which was used to reduce substance misuse during the COVID-19, found that the bond subscale rating was higher than task and goal subscales ratings (50).”
From Digital Therapeutic Alliance With Fully Automated Mental Health Smartphone Apps: A Narrative Review (2022) · cites this paper as [50]
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“However, two studies showed that users could potentially build a bond with chatbot apps.”
From Digital Therapeutic Alliance With Fully Automated Mental Health Smartphone Apps: A Narrative Review (2022) · cites this paper as [50]
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“Clarke et al. (14) measured number of program interactions (i.e., logins), number of modules completed, and frequency of self-monitoring, while Prochaska et al. (50) measured days used, in-app text messages, and completed modules.”
From Digital Therapeutic Alliance With Fully Automated Mental Health Smartphone Apps: A Narrative Review (2022) · cites this paper as [50]
In the citing paper
“Previous research demonstrated Woebot’s feasiblity and acceptability as well as efficacy to reduce (1) depression and anxiety among young adults [20], (2) depression among postpartum women [32,33], and (3) substance abuse among adults [34,35].”
From Chatbot-Delivered Cognitive Behavioral Therapy in Adolescents With Depression and Anxiety During the COVID-19 Pandemic: Feasibility and Acceptability Study (2022) · cites this paper as [35]
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Cites
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765
The PHQ-8 as a measure of current depression in the general population
Kroenke, K., Strine, T. W., Spitzer, R. L., Williams, J. B. W., Berry, J. T., & Mokdad, A. H. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.06.026 · Cited by 5,121
Skinner, H. A. (1982) · Addictive Behaviors · doi:10.1016/0306-4603(82)90005-3 · Cited by 3,134 · cited 7×
“Due to an online programming glitch, DAST-10 was not administered at EOT.”
MethodInfluentialAssessment of client/patient satisfaction: development of a general scale
Larsen, D. L., Attkisson, C. C., Hargreaves, W. A., & Nguyen, T. D. (1979) · Evaluation and Program Planning · doi:10.1016/0149-7189(79)90094-6 · Cited by 2,887 · cited 6×
“…(URP-I) Feasibility (6 items) and Acceptability (6 items) scales (Briesch et al., 2013), the 8-item Client Satisfaction Questionnaire (CSQ-8) (Larsen et al., 1979), and the Working Alliance Inventory-Short Revised (WAI-SR) with three 4-item subscales assessing development of an affective…”
BackgroundMethodInfluentialFitzpatrick, K. K., Darcy, A., & Vierhile, M. (2017) · JMIR Mental Health · doi:10.2196/mental.7785 · Cited by 2,730 · cited 4×
“W-SUDs intervention Woebot is a therapeutic relational agent that delivers CBT in the format of brief, daily text-based conversations through its own native app on iPhone and Android devices (Fitzpatrick et al., 2017).”
BackgroundMethodResultInfluentialSelf-citationCzeisler, M. É., Lane, R. I., Petrosky, E., Wiley, J. F., Christensen, A., Njai, R., Weaver, M. D., Robbins, R., Facer-Childs, E. R., Barger, L. K., et al. (2020) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6932a1 · Cited by 2,686
Development and validation of a revised short version of the working alliance inventory
Hatcher, R. L., & Gillaspy, J. A. (2006) · Psychotherapy Research · doi:10.1080/10503300500352500 · Cited by 1,355 · cited 2×
“, 1979), and the Working Alliance Inventory-Short Revised (WAI-SR) with three 4-item subscales assessing development of an affective bond in treatment and level of agreement with treatment goals and treatment tasks (Hatcher and Gillaspy, 2006).”
MethodUnderstanding and Promoting Effective Engagement With Digital Behavior Change Interventions
Yardley, L., Spring, B. J., Riper, H., Morrison, L. G., Crane, D. H., Curtis, K., Merchant, G. C., Naughton, F., & Blandford, A. (2016) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2016.06.015 · Cited by 1,118
Chatbots and Conversational Agents in Mental Health: A Review of the Psychiatric Landscape
Vaidyam, A. N., Wisniewski, H., Halamka, J. D., Kashavan, M. S., & Torous, J. B. (2019) · The Canadian Journal of Psychiatry · doi:10.1177/0706743719828977 · Cited by 1,048
It's only a computer: virtual humans increase willingness to disclose
Lucas, G. M., Gratch, J., King, A., & Morency, L.-P. (2014) · Computers in Human Behavior · doi:10.1016/j.chb.2014.04.043 · Cited by 977 · cited 2×
“…suggests that people are more likely to disclose personal information when they believe the interactions are computerrather than human-monitored (Lucas et al., 2014); and a strong therapeutic alliance can develop in the absence of face-to-face contact (Cook and Doyle, 2002), even with a…”
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Metadata
- Authors
- Prochaska, J. J., Vogel, E. A., Chieng, A., Baiocchi, M., Maglalang, D. D., Pajarito, S., Weingardt, K. R., Darcy, A., & Robinson, A.
- Affiliations
- Stanford Medicine (US)
- Stanford University (US)
- Woebot Health (United States) (US)
- Corresponding author
- Prochaska, Judith J.
- ORCID
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2021-10
- Volume
- 227
- Pages
- 108986
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC8423936
- OpenAlex
- W3196926390
- Cited by
- 113
- References
- 34
- Citations by year
- 2026: 42 · 2025: 17 · 2024: 24 · 2023: 22 · 2022: 8
- FWCI
- 12.12
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Drug and Alcohol Dependence (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (44-D048712, 32HL007034)
- National Institute on Drug Abuse (44-D048712, 32HL007034)
- National Heart, Lung, and Blood Institute (44-D048712, 32HL007034)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- substance use disorders, COVID-19 pandemic, digital health interventions, chatbot therapy, alcohol consumption, cannabis use, substance use reduction, depression, anxiety, craving, user satisfaction
- MeSH terms
- COVID-19, SARS-CoV-2, Adult, Female, Humans, Male, Mental Health, Substance-Related Disorders, Pandemics
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